Repeated Scaling Versus Surgery in Young Adults With Generalized Advanced Periodontitis

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Abstract

Background:

Residual probing depth (PD) after subgingival scaling can be treated with repeated scaling or periodontal surgery. Ambiguous results about the additional clinical benefit of a second scaling procedure exist. Therefore, we performed a prospective study comparing the clinical results of repeated subgingival scaling versus periodontal surgery in 30- to 40-year-old subjects with generalized advanced periodontitis.

Methods:

Twenty-six subjects (mean age, 37 ± 3 years) were treated after an initial examination (t1), initial subgingival scaling, and baseline examination (t2) with a randomly assigned second subgingival scaling (test) and periodontal surgery (control) in a split-mouth design. The final examination (t3) took place 6 months postoperatively. Intraindividual comparisons of mean PD and clinical attachment level (CAL) were analyzed.

Results:

PD was reduced from 4.1 ± 0.2 mm initially (t1) to 3.1 ±0.1mm at baseline (t2), and to 2.9 ±0.1mm at the end of the study (t3) for the test sites; and from 4.5 ± 0.2 mm (t1) to 3.5 ± 0.1 mm (t2), and 3.1 ± 0.1 mm (t3) for the control sites. The total PD decrease from t1 to t3 was significant (P<0.001) for both therapies. PD reduction from t2 to t3 was only significant (P<0.001) for control sites, resulting in a significant (P= 0.010) difference between test and control at the final examination. CAL increased 0.2 ± 0.1 mm (t2) plus 0.3 ± 0.1 mm (t3) for the test sites and 0.2 ± 0.1 mm (t2) plus 0.2 ± 0.1 mm (t3) for the control sites. Total CAL gain was statistically significant for the test and control sites. CAL gain from t2 to t3 was only significant (P= 0.022) for the test sites.

Conclusions:

Both treatments reduced PD and increased CAL. A second subgingival scaling resulted in significant additional CAL gain and reduced the need for surgery. J Periodontol 2008;79:1006–1013.

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